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Survivor guilt (?)

Prostate Cancer | Last Active: 21 hours ago | Replies (45)

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Fortunately, the cases where “… it can often develop and metastasize in the year between annual screenings…” are so rare that it wouldn’t even make the evening news.

That’s also the reason why when PSA is being tested, both the % Free PSA and the PSA Doubling Time should also be tracked. Those additional datapoints may give an indication that something more serious might be lurking unseen that the PSA test might be missing. Also, these days there’s a PSE test that can be used that is more sensitive than the standard PSA test.

As for the DRE, these days many centers are moving away from that. The data show that if an irregular prostate is felt, that 50% of the time it’s benign; and of the 50% that were cancerous, 95% of the time an MRI would’ve picked that up anyway. (So, the value of DREs is being questioned these days, especially since many men are skipping PSA tests just to avoid getting a DRE.) If an elevated PSA is found, and other possibilities are ruled out, then go straight to the mpMRI,

How old were you when you were initially diagnosed with prostate cancer?

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Replies to "Fortunately, the cases where “… it can often develop and metastasize in the year between annual..."

Unfortunately, they're increasing and attracting some media notice: while they're drowned out by the majority of prostate cancer cases, PCa is so common that even 5% of them as the serious type accounts for what should be a huge health crisis. The recommendation in the U.S., Canada, and elsewhere to stop routine PSA screening has definitely exacerbated the problem, though as I mentioned, even with annual screening, this one can easily slip through.

The other consideration is that the serious type of prostate cancer disproportionately affects the Black community (of which I'm not a member), and we know from many medical studies that diseases in that category are often under-reported and under-treated. 🙁

"How old were you when you were initially diagnosed with prostate cancer?"

I was 56 with a de-novo metastatic prostate cancer diagnosis, which is right in the middle of the typical age range for that type. The common, more-mild type typically manifests itself later in life. Some more-famous examples of the early-onset, aggressive type of prostate cancer:

- Musician Johnny Ramone (died age 55)
- Canadian politician Jack Layton (died age 61, just 2 years after initial diagnosis)
- Music and composer Frank Zappa (died age 52)
- Actor James Michael Tyler ("Gunther" on Friends, died age 59)
- Actor Gary Cooper (died age 60)
- Musician Dan Fogelberg (died age 56)
- Actor Bill Bixby (the Incredible Hulk, died age 59)
- Brazilian soccer star Marinho (died age 59)

Until very recently, this type of prostate cancer was considered unstoppable, and expected survival time was often short. It's just 5–10 years ago that that started to change, and now we suddenly have the hope of a longer life that was denied to those men (and the many thousands of non-famous ones in the same situation).